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[腹腔镜手术与开腹手术治疗结肠癌后的安全性及长期生存情况]

[The safety and long-term survival after laparoscopic surgery versus open surgery for colon cancer].

作者信息

Zhao Li-ying, Wang Ya-nan, Yu Jiang, Deng Hai-jun, Hu Yan-feng, Mou Ting-yu, Li Guo-xin

机构信息

Department of General Surgery, Nanfang Hospital, Nanfang Medical University, Guangzhou 510515, China.

出版信息

Zhonghua Wai Ke Za Zhi. 2013 Apr;51(4):314-9.

Abstract

OBJECTIVE

To evaluate the short-term outcomes and 5-year recurrence, overall survival, and disease-free survival of laparoscopic assisted surgery for colon cancer.

METHODS

The clinical and pathologic data were compared between the patients who underwent colectomy during March 2003 to July 2008 and assigned in laparoscopic group (n = 92) and open group (n = 285) according the surgical approach. The 5-year overall survival, disease-free survival, and recurrence rate were analyzed for all patients who were followed-up for more than 36 months in either of the groups.

RESULTS

The laparoscopic colectomy was associated with manifested less blood loss (50(50) ml) (Z = -8.292, P < 0.01), early return of bowel function (the evacuation time was (3.0 ± 1.0) days, and the meal time after operation was (4.0 ± 1.3) days) (t = -6.475 and -4.871, P < 0.01), and longer length (cm) of distal resection margin ((10 ± 4) cm vs. (9 ± 4) cm, t = 3.527, P = 0.000). The 5-year overall survival of the laparoscopic group and the open group were 63.6% and 61.8% respectively. The 5-year disease-free survival of the I-III stage patients in the laparoscopic group and the open group were 69.5% and 65.5% respectively, and the local recurrence were 8.7% and 13.6% (all P > 0.05).

CONCLUSION

The laparoscopic colectomy for colon cancer is safe in short-term clinical results and non-inferior to the open colectomy in long-term oncological outcomes.

摘要

目的

评估腹腔镜辅助结肠癌手术的短期疗效及5年复发率、总生存率和无病生存率。

方法

比较2003年3月至2008年7月期间接受结肠切除术的患者的临床和病理数据,根据手术方式将其分为腹腔镜组(n = 92)和开放组(n = 285)。对两组中随访超过36个月的所有患者分析其5年总生存率、无病生存率和复发率。

结果

腹腔镜结肠切除术的术中出血量较少(50(50) ml)(Z = -8.292,P < 0.01),肠道功能恢复较早(排气时间为(3.0 ± 1.0)天,术后进食时间为(4.0 ± 1.3)天)(t = -6.475和-4.871,P < 0.01),远端切缘长度(cm)更长((10 ± 4) cm对(9 ± 4) cm,t = 3.527,P = 0.000)。腹腔镜组和开放组的5年总生存率分别为63.6%和61.8%。腹腔镜组和开放组I-III期患者的5年无病生存率分别为69.5%和65.5%,局部复发率分别为8.7%和13.6%(均P > 0.05)。

结论

腹腔镜结肠癌手术短期临床效果安全,长期肿瘤学结局不劣于开放结肠切除术。

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